Tech Helps Oak Street Health Power Its Growth Through the Pandemic

A modified Greenway EHR fuels expansion of primary care clinics for the Medicare generation

Using a modified version of the Greenway electronic health record software platform, Oak Street Health has been riding a dramatic growth curve through the COVID-19 pandemic.

As of last November, the Chicago-based primary care provider operates 110 centers, up from 67 at the end of September 2020. Total revenue for the third quarter of 2021 was $388.7 million, up 78% year over year.

Co-founder and Chief Medical Officer Griffin Myers, MD, says technology serves the unique approach of Oak Street, which focuses on value-based care, spending extra time with patients, and high-quality health outcomes to maximize the clinic’s appeal.

"It’s a vulnerable group of patients," he says. "We are focused entirely on what matters to patients.”

“What patients care about tends not to be what I think most doctors think it is,” he adds. “It is not how charming you are in the exam room. It’s ‘Can’t I get an appointment when I need it? Do you make me wait? Do you keep me on hold? Can I get my questions answered? Can I get my test results?’ Things like that."

Oak Street Health Co-founder and CMO Griffin Myers, MD. Photo courtesy Oak Street Health.

Oak Street sees its patients an average of nine times a year, with the sickest 5% of patients connecting, on average, 19 times per year, Myers says.

"The average Medicare patient sees their primary care doctor three times a year,” he points out, adding that the average Medicare patient nationwide only sees his or her primary care provider three times a year. “Our visits are twice as long as the national ambulatory healthcare survey averages."

Patients interact with the same staff in their care team from visit to visit, including through 24/7 phone support, next-day visits, and telemedicine visits. Oak Street centers also offer transportation to and from patients’ homes, and each center includes a 1,500-square-foot community center facility for health education, Myers says.

Since its founding in 2012, Oak Street Health has driven an approximately 51% reduction in patient hospital admissions compared to Medicare benchmarks, a 42% reduction in 30-day readmission rates and a 51% reduction in emergency department visits, all while maintaining a net promoter score of 90 across patients, according to the company.

Technology Makes a Difference

Technology has allowed Oak Street to deliver high-quality care across the patient lifecycle as a matter of routine, Myers says.

"We have technology built to help us onboard new patients, manage their referrals and their interaction with the rest of the healthcare system, and help them through transitions when they do have to go to the hospital," he says.

With last October’s acquisition of RubiconMD, Oak Street expanded into virtual specialty care.

"We're all really excited about the Rubicon acquisition because it means we're able to democratize specialty care in our communities in a way that's consistent with our values and built into our platform," Myers says. "We are able to bring specialty care to patients in a way that we couldn't before, reducing the need for patients to find transportation or manage medical records on their own. This is certainly better for patients, and we believe it's an important addition to the Oak Street platform as well."

Despite Oak Street’s continued growth, Myers notes that "the pandemic has been really disruptive to our patients’ lives.”

“It has made it harder and harder for people who already found it hard to engage with a primary care model to do that,” he says. “It’s reminded us at a societal level how important primary care, community health, and public health and access is. We’re definitively existed to get on the other side of this, where it’s gone."

The pandemic also disrupted Oak Street’s outreach efforts. In 2019, the company did more than 20,000 community events.

"We couldn’t do that in 2020," Myers says. "While we’ve restarted, we’re not where we’d like to be, because it’s hard to get people in groups right now safely."

A Timely Acquisition

Oak Street has also been buoyed by last fall’s announcement by the AARP as the only primary care provider to carry the AARP name. In addition, Oak Street is one of the very few groups named both times the American Medical Association’s Joy in Medicine Health System Recognition Program has been announced, in 2019 and 2021.

"Our physician burnout rates are very low compared to the rest of the country, but still not zero," Myers says. "Our turnover rates in that cohort are under half the national average. It's proof that we're doing this right. We are adding hundreds of new primary care providers every year, in an environment that is supply constrained.”

Despite that, Oak Street asks its clinicians "to do really hard work," he adds. "Unlike the rest of the healthcare system, we hold them accountable to a certain quality of care. That comes with pressure. In addition, we're doing that in communities and populations that have a very high disease burden. They witness a lot of suffering every day. And that's really, really hard. So I don't want these jobs to be easy. I want them to be meaningful, and they are meaningful."

Several times a year, Oak Street shuts down the practice to do grand rounds, including brining in guest speakers.

At present, Oak Street operates in 20 states across the U.S. "We'd like to be everywhere," Myers says. Entering new markets involves identifying communities where health equity gaps persist, with a critical mass of low-income seniors who lack primary care.

"Unfortunately, there’s a lot of places like that in our country," he adds.

"Our technology has helped us not only to grow and make the patient experience great, but it also gives us a scalable platform to care for more patients and offer a greater breadth of services to them," Myers says.